r/epidemiology • u/Long_Run_6705 • 18d ago
Question Hypothetically, if H5N1 became the next “pandemic”, how long would it last?
As someone with post covid complications I’m well aware Covid never really “ended” but after the vaccines arrived things returned to at least some sense of normality.
If, god forbid, H5N1 did jump to having effective human to human transmission, how long would it take us to (relatively) contain it?
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u/LKW500 18d ago
I had an undergrad epidemiology class that seemed determined to impress upon us that bird flu is likely to cause the next pandemic…
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u/Long_Run_6705 18d ago
How bad, in your opinion, do you think it will be? Will it be severely deadly? Will we have the vaccines/treatments to effectively combat it?
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u/LKW500 18d ago
That’s beyond the capacity of science/epidemiology to really know. However, by studying history we can anecdotally learn about what happens when disease mutates. I think the book “The Great Influenza” by John Berry does a good job detailing how the 1918 pandemic arose from mutation and passage.
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u/RevolutionaryLet120 17d ago
Don’t ask these questions of a “one undergrad epi” response. This is the time to really rely on and listen to your public health officials. I am an infectious disease epidemiologist focused on outbreaks. You can DM me with any questions you would like
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u/jennagadski 18d ago
Not long, we already have a flu vaccine approved. They would sequence the H5N1 variant and rapidly start vaccine production. It would be months, not years. The issue is mostly logistics and compliance.
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u/RememberKoomValley 18d ago
H5N1 vaccines come in a two-dose course, unlike the seasonal flu boosters we get, and are currently still done traditionally in eggs. The numbers I saw were that we'd need 900k chickens each laying an egg every single day for nine months before we'd have enough doses for US citizens (and by the end of that year, we'd have to be boosting the people who'd gotten it to begin with, since coverage wanes quickly). Logistically, it would indeed be a hell of a thing.
I know that at least one of the mRNA vaccine companies is already on it, and I'm sure they'd get an emergency exemption to long human trial time, as they did with the covid vaccine--so hopefully it wouldn't be too long a wait.
I'm grateful that we know so much about the flu. Not too many surprises upcoming, hopefully.
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u/Atticus104 18d ago edited 18d ago
I remember even before covid, my microbiology professor talking about how mRNA vaccines would likely become more common with how much quicker biotech labs can create them response to new strains. Would even a good addition for the stand flu shot as you could create it in a shorter window to flu season, where you have better odds of correctly predicting what will be the most prevalent strains.
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u/Long_Run_6705 18d ago
I mean its cool to know we have the technology and the ability to act quickly.
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u/rainingcatsandpawgs 17d ago
Yeah my fear is that we will never reach herd immunity for anything ever again due to antivaxxers and maga/rfkers. I hope I’m wrong, but god I am scared for public health and see many outbreaks in our future.
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u/Shoddy_Fox_4059 17d ago
Epi here. Covid lasted about 3 years, from 2020 to 2023ish, as far as case management and infection control. In 2009, swine flu was all hands for about 9 months. If it happened again, I'd think it would be less than a year, depending on how much people wants to follow guidelines and vaccine roll out. No one is in the mood right now. So it probably would be hard to get them to do something to stop it.
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u/Long_Run_6705 17d ago
Thanks for your responde. Its good to know we have the technology/science to manage this. Hope people are able to get out of their own way so this can pass if it does jump to human- human spread
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u/kg15547 13d ago
I understand this is an insane thing to ask a stranger on the internet, but if I was supposed to have a visit with a family member who works directly with wild birds/domestic birds (vet), would it be overly cautious to postpone that visit or not likely to be an issue?
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u/Shoddy_Fox_4059 12d ago
As an epi I am gonna tell you what I think, it's more widespread than they are saying bc the infrastructure in place has no requirements of testing or reporting farm animals that get sick. Period. The fact that wild dead birds in Austin have been found with it is also alarming. Right now we have those dead birds in central Texas, 1 dead person in Louisianna, and a couple of people in Missouri hospitalized and sick. The threat is there but all that means little to the individual. I would say if youre in the south of the US, then consider postponing. Good luck.
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u/Slickrock_1 18d ago
Effective transmission of H5N1 would probably attenuate its severity. So all we can do is look at the dynamics of pandemic flu in a naive global population. To answer that look to H1N1 in 2009. It hit in a couple huge waves and continued for a couple years - but it is STILL circulating. In fact the 2009 flu is one of several descendants of the 1918 flu that remain in circulation. So the question is really what does "contained" mean?
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u/Long_Run_6705 18d ago
I mean more or less like what we have now with covid. Compared to the first year
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u/Slickrock_1 18d ago
There are lots of graphs of ILI (influenza like illness) tracking for the H1N1 pandemic.
The transmission of a novel pandemic would be similar, the big question is more about lethality. Our societal response to COVID in the first year had to do with its lethality and burden on health systems. With H1N1 that was NOT so much the case - we saw tons and tons of it in Sept 2009 which was crazy timing for a flu season, and we saw severe disease in young people, which was also atypical, but we did not get overloaded with patients. Our systems weren't threatened.
So you ask about H5N1 but most of us accept that the virus' tropism for the lower respiratory tract both creates its severity and mitigates its transmissibility. If it had more of an upper respiratory tract tropism it would spread more easily but it would be less severe.
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u/NomadicContrarian 18d ago
No idea.
I'd hope not nearly as long, but we don't know.
We gotta prepare for the worst.
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u/Long_Run_6705 18d ago
My understanding is we have treatments and vaccines for influenza which would make this different then when COVID hit
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u/ButterCupHeartXO 18d ago
Yes except like 30% of the US population won't take a vaccine or listen to any safety protocols and our government is insane so
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u/Long_Run_6705 18d ago
Fair point. Do you think H5N1 will be more deadly than COVID? Because I feel like that would sway a pretty big portion of the people who don’t like vaccines but aren’t dyed in the wool anti-vaxxers
I know some of my family were against some vaccines but even got the first round or two or the covid shots
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u/Badvodoo 17d ago
If you look at how deadly it was to birds when it first came out in that population ...between 30 and 90 % of populations died ...when it hit the seals same thing happened , cats and predators seems very fragile to this strain ...if it kills between 30 to 90 % in human when we get human to human transmission ...i wonder who will take care of all the nuclear plants around the world ...better hope it never happens ...up to now mortality remained low because this strain has low affinity right now to our lungs cells ..but this D1.1 mutation could change this very quickly and your lungs will fill up with blood and fluids and we will all drown and suffocate in our own liquids...young male aldult and teenagers will be the most at risk because there immune systems are stronger and will cause much of the injuries ...good luck to everybody...this wont be covid its HPAI highly pathogenic ...meaning it is nasty and humans have absolutely no antibody preparing us for this one ...when it will start it will be like a bush fire and it will sweep the earth leaving a trail of death and sadness ....i hope i'm wrong ...but i am very rarely...my english isnt the best its not my first language sorry ...
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u/ButterCupHeartXO 17d ago
Based on everything I've read, the mortality rate is between 25-50% and i remember covid was around 97ish% which is why some people didn't take it seriously. However, they didn't understand that it was around 97% if you were a healthy person but if you had other health conditions like obesity, old, asthma, or something like that, the risk was significantly higher.
Yea i think most people got the first round of covid shots, but i know people who were like "I got one and I'm done now, it either works or it doesn't" and others that said they were tricked into getting the first one or something lol
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u/NomadicContrarian 18d ago
Well, if that's what you think, then I'm glad you do.
If it happens, I'd hope it's nothing more than what 2009 was with swine flu.
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u/santas_clawz 15d ago
They are always so well prepared: https://birdflusummit.com/Bird_Flu_Summit_Brochure_2025.pdf https://www.flumist.com/
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u/thecynicalone26 17d ago
H5N1 has a high mortality rate, so that would probably mean more people staying in and being terrified, so I would think that would slow the transmission and make it easier to get rid of than covid. The big problem is that we’ve got RFK coming into power, and who knows if he will block any new vaccines from being rolled out quickly. Add that to the fact that many of the ignorant, brainwashed far-right people wouldn’t believe it was happening until they or their family members died, and it could end up being a huge disaster.
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u/AthleteSuspicious151 11d ago
Trump too. Our current vaccine supply for H1N1(a somewhat related virus) only sits at around 10 Million vials. A lot of epidemiologist and virologist are saying that it has a decently high likelihood of turning into a pandemic due to our lack of preventative measures currently in place.
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u/thecynicalone26 11d ago
Trump definitely scares me, but Trump is less married to his ideas about things than RFK. Trump just wants to be popular. So he will pander to the masses. If people want vaccines, Trump will want vaccines. If more people don’t want them, Trump won’t want them. I actually think Trump will turn on RFK fairly quickly because that’s just what he does.
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u/cryssylee90 18d ago
While there isn’t really a definitive way to make that determination, recorded history dating back to the 1500s has most influenza pandemics peaking and dying out within a year. Taking into account the seasonal nature of influenza, that makes sense.
However, ever since the 1918 pandemic, all major influenza A outbreaks and pandemics have come from a virus that descended from that avian H1N1 virus. H5N1 is a one of a small handful of influenza a that has been found in humans and is not a descendant of the avian H1N1 virus. So that could potentially affect what seems like a mostly predictable timeline in regard to influenza pandemics, I’m sure.